<!DOCTYPE html>
<html>
<head>
<meta charset="UTF-8">
<title>个人信息</title>
<link rel="stylesheet" type="text/css" href="common/bootstrap/css/bootstrap.css" media="all">
<script type="text/javascript" src="common/bootstrap/js/jquery.min.js"></script>
<link href="common/bootstrap/css/bootstrap.min.css" rel="stylesheet">
<script src="common/bootstrap/js/bootstrap.min.js"></script>
<script type="text/javascript" src="js/pregnancy.js"></script>
<script type="text/javascript" src="js/addMarriage.js"></script>
</head>
<body>
	<div class="container">
		<form id="form" class="form-horizontal" role="form">
			<div class="form-group col-sm-12" style="height: 50px;">
				<h2><small style="color: red;"><b>计生信息：</b></small></h2>
			</div>
	        <div class="form-group col-sm-12">
	            <label for="firstname" class="col-sm-2 control-label">夫妻同行:</label>      
	            <div class="col-sm-2"> 
	            	<label class="radio-inline">
					  <input type="radio" id="inlineradio1" name="husband" value="1"> 是
					</label>
					<label class="radio-inline">
					  <input type="radio" id="inlineradio2" name="husband" value="0"> 否
					</label>        
	             </div> 
	            <label for="firstname" class="col-sm-2 control-label">婚育证明:</label>      
	            <div class="col-sm-2">         
	               <label class="radio-inline">
					  <input type="radio" id="inlineradio1" name="babyCertificate" value="1"> 是
					</label>
					<label class="radio-inline">
					  <input type="radio" id="inlineradio2" name="babyCertificate" value="0"> 否
					</label>
	            </div>  
	            <label for="firstname" class="col-sm-2 control-label">是否验证:</label>      
	            <div class="col-sm-2">         
	            	<label class="radio-inline">
					  <input type="radio" id="inlineradio1" name="validation" value="1"> 是
					</label>
					<label class="radio-inline">
					  <input type="radio" id="inlineradio2" name="validation" value="0"> 否
					</label>
	            </div>
	        </div>
	        <div class="form-group col-sm-12">
	            <label for="firstname" class="col-sm-2 control-label">婚育证编码:</label>      
	            <div class="col-sm-4">         
	               <input type="text" class="form-control" name="babyNumber" id="firstname" placeholder="请输入婚育证编码"> 
	            </div>
	        </div>
	        <label for="firstname" class="col-sm-2" >生育情况:</label> 
	        <div class="form-group col-sm-12">
	        	<label for="firstname" class="col-sm-2">生育子女数:</label>
	            <label for="firstname" class="col-sm-1 control-label">女</label>      
	            <div class="col-sm-1">         
	            	<input type="text" class="form-control" name="childrenWomen" id="firstname"> 
	            </div>
	            <label for="firstname" class="col-sm-1 control-label text-left">人</label>
	            <label for="firstname" class="col-sm-2 control-label">男</label>      
	            <div class="col-sm-1">         
					<input type="text" class="form-control" name="childrenMale" id="firstname">
	            </div>
	            <label for="firstname" class="col-sm-1  control-label text-left">人</label>
	        </div>
	        <div class="form-group col-sm-12">
	            <label for="firstname" class="col-sm-3 control-label">政策内:</label>      
	            <div class="col-sm-2">         
	            	<label class="radio-inline">
					  <input type="radio" id="inlineradio1" name="policyIn" value="1">2孩
					</label>
					<label class="radio-inline">
					  <input type="radio" id="inlineradio2" name="policyIn" value="0">3孩
					</label>
	            </div>
	            <label for="firstname" class="col-sm-2 control-label">政策外:</label>      
	            <div class="col-sm-3">         
					<label class="radio-inline">
					  <input type="radio" id="inlineradio1" name="policyOutside" value="1"> 2孩
					</label>
					<label class="radio-inline">
					  <input type="radio" id="inlineradio2" name="policyOutside" value="0"> 3孩
					</label>
	            </div>
	        </div>
	        <div class="form-group col-sm-12">
	            <label for="firstname" class="col-sm-2 control-label">独生子女:</label>      
	            <div class="col-sm-2">         
	            	<label class="radio-inline">
					  <input type="radio" id="inlineradio1" name="certificate" value="1"> 有
					</label>
					<label class="radio-inline">
					  <input type="radio" id="inlineradio2" name="certificate" value="0">无
					</label>
	            </div>
	            <label for="firstname2" class="col-sm-2 control-label" >社会抚养费征收:</label>      
	            <div class="col-sm-3">         
					<label class="radio-inline">
					  <input type="radio" id="inlineradio1" name="maintenance" value="1"> 已缴费
					</label>
					<label class="radio-inline">
					  <input type="radio" id="inlineradio2" name="maintenance" value="0">未缴费
					</label>
	            </div>
	        </div>
	        <div class="form-group col-sm-12">
	            <label for="firstname" class="col-sm-2 control-label">怀孕避孕情况:</label>      
	            <div class="col-sm-2">         
	            	<select name="pregnancyId" id="pregnancy" class="form-control">
					</select>
	            </div>
	            <label for="firstname" class="col-sm-2 control-label">措施时间:</label>      
	            <div class="col-sm-3">         
					<input name="measuress" id="" type="date" class="form-control">
	            </div>
	        </div> 
	        <div class="form-group col-sm-12" >
	            <label for="firstname" class="col-sm-2 control-label">当年生育子女:</label>      
	            <div class="col-sm-2">         
	            	<label class="radio-inline">
					  <input type="radio" id="inlineradio1" name="birth" value="1"> 男
					</label>
					<label class="radio-inline">
					  <input type="radio" id="inlineradio2" name="birth" value="0">女
					</label>
	            </div>
	            <label for="firstname" class="col-sm-2 control-label">出生日期:</label>      
	            <div class="col-sm-3">         
					<input name="birthDates" type="date" id="" class="form-control">
	            </div>
	            <label for="firstname" class="col-sm-1 control-label">政策:</label>      
	            <div class="col-sm-2">         
	            	<label class="radio-inline">
					  <input type="radio" id="inlineradio1" name="policy" value="1"> 内
					</label>
					<label class="radio-inline">
					  <input type="radio" id="inlineradio2" name="policy" value="0">外
					</label>
	            </div>
	        </div>
	        <div class="form-group col-sm-12">
	            <label for="firstname" class="col-sm-2 control-label"></label>  
			    <div class="col-sm-8">         
				  <input type="button" id="pe" class="btn btn-primary btn-block" value="下一项（保存）" />     
			    </div>
	        </div>
	        <div class="form-group col-sm-12" style="height: 50px;"> </div>
        </form>
	</div>	
</body>
</html>